阻断血液回流对干细胞治疗大鼠阴茎勃起功能障碍的影响

The effect of blocking penile blood drainage on stem cells therapy for rats with erectile dysfunction

目的探讨阻断阴茎血液回流对干细胞治疗大鼠阴茎勃起功能障碍(ED)的细胞滞留、勃起功能改善及组织病理变化的影响。方法采用随机数法将30只雄性SD大鼠分为假手术组(6只)、ED模型组(6只)、治疗组A(9只,阻断阴茎根部血液回流)及治疗组B(9只,不阻断阴茎根部血液回流)。模型建立24 h后,治疗组A及治疗组B经海绵体注射总细胞数量为1×10^6的脂肪干细胞(ADSCs)。干细胞注射前,治疗组A暂时性阻断阴茎血液回流,并于注射后5 min放开。注射后,检测阴茎局部生物发光信号动态变化及肺内信号。注射28 d后,检测最大海绵体内压/平均动脉压(ICPmax/MAP),评估阴茎勃起功能,并观察组织病理变化。结果治疗组A与治疗组B相比,各时间点(0、10、60 min)大鼠阴茎内生物发光信号强度(×10^6·p·s^-1·sr·cm^-2)差异均无统计学意义(8.76±1.17比8.16±1.12,6.45±1.47比6.72±0.69,3.77±0.30比3.36±1.06,均P>0.05)。注射60 min后,治疗组A与治疗组B均能在肺脏观察到大量ADSCs聚集;不论是否阻断阴茎血液回流,ADSCs对阴茎勃起功能(ICPmax/MAP为0.44±0.11比0.43±0.07)及组织病理变化(平滑肌/胶原比值为0.08±0.02比0.08±0.03)改善情况不显著,差异均无统计学意义(均P>0.05)。结论暂时性阻断阴茎血液回流对提高干细胞在大鼠阴茎内滞留及改善ED治疗效果无明显优势。

Objective To investigate the effect of blocking penile blood drainage at the root of the rat penis on cell retention,penile erectile function,and histopathological changes when erectile dysfunction(ED)is treated by intracavernous injection(ICI)of stem cells.Methods Thirty male SD rats were randomly divided into sham operation group(n=6),ED model group(n=6),treatment group A(blockade group,n=9)and treatment group B(non-blockade group,n=9).Twenty-four hours after the model was established,group A and group B were treated by ICI of 1×10^6 adipose-derived stem cells(ADSCs).Before ICI,the penile blood drainage in group A was temporarily blocked with a rubber tourniquet at the root of the penis which was removed 5 minutes after the injection.The dynamic changes of the local fluorescent signal of the penis and the expression of the fluorescent signal in the lung were detected after ICI.The maximum intracavernous pressure/mean arterial pressure(ICPmax/MAP)was measured to evaluatethe erectile function,and histopathological changes of the penis were observed after 28 days.Results At different time points(0,10 and 60 min),the intensity of the bioluminescent signal(×10^6·p·s^-1·sr·cm^-2)in group A had a similar trend when compared with that in group B,and the differences were not statistically significant(8.76±1.17 vs 8.16±1.12,6.45±1.47 vs 6.72±0.69,3.77±0.30 vs 3.36±1.06,all P>0.05).A large number of ADSCs could be found in the lungs in both treatment groups after 60 min of ICI.There was no statistically significant difference in erectile function(0.44±0.11 vs 0.43±0.07)and histopathological change(0.08±0.02 vs 0.08±0.03)regardless of the occlusion of blood drainage at the root of the penis(all P>0.05).Conclusion Temporarily blocking of penile blood drainage has no obvious advantage in improving cell retention and efficacy when ADSCs are used to treat ED of rat models.